谭卉晗,王鉴
TAN Huihan,WANG Jian

• 1:贵州医科大学
• 2:贵州医科大学附院新生儿科

摘要(Abstract)：

目的:探讨肺泡表面活性物质(PS)对不同性别呼吸窘迫综合征(NRDS)早产儿的治疗效果。方法:112例早产NRDS患儿,男94例、女28例,记录两组NRDS患儿出生体质量、胎龄、Apgar评分、母亲产前是否使用激素等基本临床资料,观察PS治疗前及治疗后6、12及24 h的氧分压(PaO_2)、氧合指数(P/F)、治疗后并发症[肺部感染、气胸、动脉导管未闭(PDA)、支气管肺发育不良(BPD)、颅内出血(ICH)、肺出血]、治疗时间(机械通气时间、氧疗时间、住院时间)及死亡例数发生情况。结果:各组患儿经PS治疗后6、12及24 h时的血液PaO_2均较治疗前升高,差异有统计学意义(P<0.05);女性患儿治疗后各时间点血液PaO_2较男性患儿组高,在治疗后6 h时比较差异有统计学意义(P<0.05);女性患儿及所有患儿经治疗后P/F较本组治疗前上升,差异有统计学意义(P<0.05);男、女性患儿PS治疗后肺部感染、气胸、PDA、BPD、ICH发生比例比较,差异无统计学意义(P>0.05);女性患儿发生肺出血比例较男性患儿低,差异有统计学意义(P<0.05);女性患儿机械通气时间、氧疗时间均低于男性患儿,差异有统计学意义(P<0.05);女性患儿住院时间均值低于男性患儿,但差异无统计学意义(P>0.05);男性患儿PS治疗后死亡比例明显高于女性患儿,差异有统计学意义(P<0.05)。结论:PS对不同性别NRDS早产患儿疗效不同,对女性患儿的治疗效果优于男性。
Objective: To investigate the clinical efficacy of pulmonary surfactant(PS) therapy in different genders premature infant diagnosed with respiratory distress syndrome(NRDS). Methods: 112 premature infants diagnosed with NRDS(94 males and 28 females), recording clinical data, including birth weight, gestational age, Apgar score, antepartum hormone treatment in mother or not. Observing PaO_2, P/F, postoperative complications(pulmonary infection, aerothorax, PDA, BPD, ICH and pulmonary hemorrhage), treatment time(mechanical ventilation time, oxygen treatment time and hospitalization time) and number of death cases before treatment and 6 h, 12 h and 24 h after PS treatment. Results: All infant patients showed an PaO_2 improvement in blood 6 h, 12 h and 24 h after PS treatment compared with before treatment, differences were statistically significant(P<0.05); blood PaO_2 of female newborns was higher than that of male newborns at each time point after treatment, and the difference was statistically significant only 6 h after treatment(P<0.05). Compared with before treatment, P/F increased in female newborns and in general newborns after treatment compared with before treatment in its own group, difference was statistically significant(P<0.05); after PS treatment, incidence number of pulmonary infection, aerothorax, PDA, BPD, ICH between male and female infant patients showed no statistical significance(P>0.05); female infant patients showed less pulmonary hemorrhage rate than male counterparts, difference was statistically significant(P<0.05). The mechanical ventilation time and oxygen therapy time of female infant patients were shorter than that of males, difference was statistically significant(P<0.05). The mean hospitalization time of female infant patients was less than that of males, difference was not statistically significant(P>0.05). The death rate of male infant patients was significantly higher than that of females, difference was statistically significant(P<0.05). Conclusions: PS has different therapeutic effects on NRDS infant patients of different genders, and females showed better efficacy than males.

关键词(KeyWords)： 肺表面活性物质;新生儿呼吸窘迫综合征;新生儿;性别;血气分析
pulmonary surfactants;neonatal respiratory distress syndrome;newborn;gender;arterial blood gas analysis

Abstract:

Keywords:

基金项目(Foundation): 贵州省科学技术基金项目[黔科合J字(2009)2160]

作者(Author): 谭卉晗,王鉴
TAN Huihan,WANG Jian

DOI: 10.19367/j.cnki.1000-2707.2019.09.017

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